Declaration Under Penalty Of Perjury For The Centers For Disease Control And Prevention's Temporary Halt In Evictions To Prevent Further Spread Of Covid-19

TEMPORARY HALT IN RESIDENTIAL EVICTIONS TO PREVENT THE FURTHER SPREAD OF COVID-19

OMB: 0920-1303

IC ID: 243342

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1303 can be found here:

Documents and Forms

Document Name Document Type
Evictions Declaration Final 28AUG2020.docx Instruction
Evictions Declaration Final 28AUG2020.docx Instruction
Evictions Declaration Final 28AUG2020_FINAL-Spanish.docx Instruction
Evictions Declaration Final 28AUG2020_FINAL-Spanish.docx Instruction
0920-1303 Evictions Declaration 29DEC2020 EvictionDeclaration_12.29.2020.docx Form and Instruction
0920-1303 Evictions Declaration 29DEC2020 EvictionDeclaration_12.29.2020.docx Form and Instruction
0920-1303 Evictions Declaration 29DEC2020_Spanish EvictionDeclaration_12.29.2020-es.docx Form and Instruction
0920-1303 Evictions Declaration 29DEC2020_Spanish EvictionDeclaration_12.29.2020-es.docx Form and Instruction
0920-1303 Evictions Declaration 29JAN2021 Eviction Declaration Form 1.29.21.docx Form and Instruction
0920-1303 Evictions Declaration 29JAN2021 Eviction Declaration Form 1.29.21.docx Form and Instruction
0920-1303 Evictions Declaration - Spanish 29JAN2021 EvictionDeclarationES 1.29.21.docx Form and Instruction
0920-1303 Evictions Declaration - Spanish 29JAN2021 EvictionDeclarationES 1.29.21.docx Form and Instruction
0920-1303 Evictions Declaration_Fillable PDF_508 322024_A_EvictionDeclare_508.pdf Form and Instruction
0920-1303 Evictions Declaration_Fillable PDF_508 322024_A_EvictionDeclare_508.pdf Form and Instruction
0920-1303 Evictions Declaration_Fillable PDF_508 - Spanish 322024_B_EvictionDeclare_esp_508.pdf Form and Instruction
0920-1303 Evictions Declaration_Fillable PDF_508 - Spanish 322024_B_EvictionDeclare_esp_508.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	DECLARATION UNDER PENALTY OF PERJURY FOR THE CENTERS FOR DISEASE CONTROL AND PREVENTION'S TEMPORARY HALT IN EVICTIONS TO PREVENT FURTHER SPREAD OF COVID-19	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Evictions Declaration Final 28AUG2020.docx	NA	Yes	Yes	Fillable Fileable
Instruction			Evictions Declaration Final 28AUG2020_FINAL-Spanish.docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1303	Evictions Declaration 29DEC2020	EvictionDeclaration_12.29.2020.docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1303	Evictions Declaration 29DEC2020_Spanish	EvictionDeclaration_12.29.2020-es.docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1303	Evictions Declaration 29JAN2021	Eviction Declaration Form 1.29.21.docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1303	Evictions Declaration - Spanish 29JAN2021	EvictionDeclarationES 1.29.21.docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1303	Evictions Declaration_Fillable PDF_508	322024_A_EvictionDeclare_508.pdf	NA	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1303	Evictions Declaration_Fillable PDF_508 - Spanish	322024_B_EvictionDeclare_esp_508.pdf	NA	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 35,000,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	35,000,000	35,000,000
Annual IC Time Burden (Hours)	2,916,667	2,916,667
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.